HEMORRHAGIC STROKE QUIZZES
WITH ACTUAL ANSWERS
Hemorrhagic stroke ANSWER :-hemorrhagic strokes are caused by bleeding into the brain tissue, the
ventricles, or the subarachnoid space.
Pathophysiology ANSWER :-The pathophysiology of hemorrhagic stroke depends on the cause and
type of cerebrovascular disorder. Symptoms are produced when a primary hemorrhage, aneurysm, or
AVM presses on nearby cranial nerves or brain tissue or, more dramatically, when an aneurysm or AVM
ruptures, causing subarachnoid hemorrhage (hemorrhage into the cranial subarachnoid space). Normal
brain metabolism is disrupted by the brain's exposure to blood; by an increase in ICP resulting from the
sudden entry of blood into the subarachnoid space, which compresses and injures brain tissue; or by
secondary ischemia of the brain resulting from the reduced perfusion pressure and vasospasm that
frequently accompany subarachnoid hemorrhage.
Intracerebral Hemorrhage ANSWER :-An intracerebral hemorrhage, or bleeding into the brain tissue, is
most common in patients with hypertension and cerebral atherosclerosis, because degenerative
changes from these diseases cause rupture of the blood vessel. An intracerebral hemorrhage may also
result from certain types of arterial pathology, brain tumors, and the use of medications (e.g., oral
anticoagulants, amphetamines, and illicit drug use).
Bleeding occurs most commonly in the cerebral lobes, basal ganglia, thalamus, brain stem (mostly the
pons), and cerebellum (Hickey, 2009). Occasionally, the bleeding ruptures the wall of the lateral
ventricle and causes intraventricular hemorrhage, which is frequently fatal.
Intracranial (Cerebral) Aneurysm ANSWER :-An intracranial (cerebral) aneurysm is a dilation of the
walls of a cerebral artery that develops as a result of weakness in the arterial wall. The cause of
aneurysms is unknown, although research is ongoing. An aneurysm may be due to atherosclerosis,
which results in a defect in the vessel wall with subsequent weakness of the wall; a congenital defect of
the vessel wall; hypertensive vascular disease; head trauma; or advancing age.
Any artery within the brain can be the site of a cerebral aneurysm, but these lesions usually occur at the
bifurcations of the large arteries at the circle of Willis . The cerebral arteries most commonly affected by
an aneurysm are the internal carotid artery, anterior cerebral artery, anterior communicating artery,
posterior communicating artery, posterior cerebral artery, and middle cerebral artery. Multiple cerebral
aneurysms are not uncommon
, Arteriovenous Malformations (AVM) ANSWER :-Most AVMs are caused by an abnormality in
embryonal development that leads to a tangle of arteries and veins in the brain that lacks a capillary
bed. The absence of a capillary bed leads to dilation of the arteries and veins and eventual rupture. AVM
is a common cause of hemorrhagic stroke in young people
Subarachnoid Hemorrhage ANSWER :-A subarachnoid hemorrhage (hemorrhage into the subarachnoid
space) may occur as a result of an AVM, intracranial aneurysm, trauma, or hypertension. The most
common causes are a leaking aneurysm in the area of the circle of Willis and a congenital AVM of the
brain
ANSWER :-The patient with a hemorrhagic stroke can present with a wide variety of neurologic
deficits, similar to the patient with ischemic stroke. The conscious patient most commonly reports a
severe headache. A comprehensive assessment reveals the extent of the neurologic deficits. Many of
the same motor, sensory, cranial nerve, cognitive, and other functions that are disrupted after ischemic
stroke are also altered after a hemorrhagic stroke. Other symptoms that may be observed more
frequently in patients with acute intracerebral hemorrhage (compared with ischemic stroke) are
vomiting, an early sudden change in level of consciousness, and possibly focal seizures due to frequent
brain stem involvement.
In addition to the neurologic deficits (similar to those of ischemic stroke), the patient with an
intracranial aneurysm or AVM may have some unique clinical manifestations. Rupture of an aneurysm or
AVM usually produces a sudden, unusually severe headache and often loss of consciousness for a
variable period of time. There may be pain and rigidity of the back of the neck (nuchal rigidity) and spine
due to meningeal irritation. Visual disturbances (visual loss, diplopia, ptosis) occur if the aneurysm is
adjacent to the oculomotor nerve. Tinnitus, dizziness, and hemiparesis may also occur.
At times, an aneurysm or AVM leaks blood, leading to the formation of a clot that seals the site of
rupture. In this instance, the patient may show little neurologic deficit. In other cases, severe bleeding
occurs, resulting in cerebral damage, followed rapidly by coma and death.
Prognosis depends on the neurologic condition of the patient, the patient's age, associated diseases,
and the extent and location of the hemorrhage or intracranial aneurysm. Subarachnoid hemorrhage
from an aneurysm is a catastrophic event with significant morbidity and
Assessment and Diagnostic Findings ANSWER :-Any patient with suspected stroke should undergo a CT
scan or MRI to determine the type of stroke, the size and location of the hematoma, and the presence
or absence of ventricular blood and hydrocephalus. Cerebral angiography confirms the diagnosis of an
intracranial aneurysm or AVM. These tests show the location and size of the lesion and provide
information about the affected arteries, veins, adjoining vessels, and vascular branches. Lumbar
puncture is performed if there is no evidence of increased ICP, the CT scan results are negative, and
subarachnoid hemorrhage must be confirmed. Lumbar puncture in the presence of increased ICP could
WITH ACTUAL ANSWERS
Hemorrhagic stroke ANSWER :-hemorrhagic strokes are caused by bleeding into the brain tissue, the
ventricles, or the subarachnoid space.
Pathophysiology ANSWER :-The pathophysiology of hemorrhagic stroke depends on the cause and
type of cerebrovascular disorder. Symptoms are produced when a primary hemorrhage, aneurysm, or
AVM presses on nearby cranial nerves or brain tissue or, more dramatically, when an aneurysm or AVM
ruptures, causing subarachnoid hemorrhage (hemorrhage into the cranial subarachnoid space). Normal
brain metabolism is disrupted by the brain's exposure to blood; by an increase in ICP resulting from the
sudden entry of blood into the subarachnoid space, which compresses and injures brain tissue; or by
secondary ischemia of the brain resulting from the reduced perfusion pressure and vasospasm that
frequently accompany subarachnoid hemorrhage.
Intracerebral Hemorrhage ANSWER :-An intracerebral hemorrhage, or bleeding into the brain tissue, is
most common in patients with hypertension and cerebral atherosclerosis, because degenerative
changes from these diseases cause rupture of the blood vessel. An intracerebral hemorrhage may also
result from certain types of arterial pathology, brain tumors, and the use of medications (e.g., oral
anticoagulants, amphetamines, and illicit drug use).
Bleeding occurs most commonly in the cerebral lobes, basal ganglia, thalamus, brain stem (mostly the
pons), and cerebellum (Hickey, 2009). Occasionally, the bleeding ruptures the wall of the lateral
ventricle and causes intraventricular hemorrhage, which is frequently fatal.
Intracranial (Cerebral) Aneurysm ANSWER :-An intracranial (cerebral) aneurysm is a dilation of the
walls of a cerebral artery that develops as a result of weakness in the arterial wall. The cause of
aneurysms is unknown, although research is ongoing. An aneurysm may be due to atherosclerosis,
which results in a defect in the vessel wall with subsequent weakness of the wall; a congenital defect of
the vessel wall; hypertensive vascular disease; head trauma; or advancing age.
Any artery within the brain can be the site of a cerebral aneurysm, but these lesions usually occur at the
bifurcations of the large arteries at the circle of Willis . The cerebral arteries most commonly affected by
an aneurysm are the internal carotid artery, anterior cerebral artery, anterior communicating artery,
posterior communicating artery, posterior cerebral artery, and middle cerebral artery. Multiple cerebral
aneurysms are not uncommon
, Arteriovenous Malformations (AVM) ANSWER :-Most AVMs are caused by an abnormality in
embryonal development that leads to a tangle of arteries and veins in the brain that lacks a capillary
bed. The absence of a capillary bed leads to dilation of the arteries and veins and eventual rupture. AVM
is a common cause of hemorrhagic stroke in young people
Subarachnoid Hemorrhage ANSWER :-A subarachnoid hemorrhage (hemorrhage into the subarachnoid
space) may occur as a result of an AVM, intracranial aneurysm, trauma, or hypertension. The most
common causes are a leaking aneurysm in the area of the circle of Willis and a congenital AVM of the
brain
ANSWER :-The patient with a hemorrhagic stroke can present with a wide variety of neurologic
deficits, similar to the patient with ischemic stroke. The conscious patient most commonly reports a
severe headache. A comprehensive assessment reveals the extent of the neurologic deficits. Many of
the same motor, sensory, cranial nerve, cognitive, and other functions that are disrupted after ischemic
stroke are also altered after a hemorrhagic stroke. Other symptoms that may be observed more
frequently in patients with acute intracerebral hemorrhage (compared with ischemic stroke) are
vomiting, an early sudden change in level of consciousness, and possibly focal seizures due to frequent
brain stem involvement.
In addition to the neurologic deficits (similar to those of ischemic stroke), the patient with an
intracranial aneurysm or AVM may have some unique clinical manifestations. Rupture of an aneurysm or
AVM usually produces a sudden, unusually severe headache and often loss of consciousness for a
variable period of time. There may be pain and rigidity of the back of the neck (nuchal rigidity) and spine
due to meningeal irritation. Visual disturbances (visual loss, diplopia, ptosis) occur if the aneurysm is
adjacent to the oculomotor nerve. Tinnitus, dizziness, and hemiparesis may also occur.
At times, an aneurysm or AVM leaks blood, leading to the formation of a clot that seals the site of
rupture. In this instance, the patient may show little neurologic deficit. In other cases, severe bleeding
occurs, resulting in cerebral damage, followed rapidly by coma and death.
Prognosis depends on the neurologic condition of the patient, the patient's age, associated diseases,
and the extent and location of the hemorrhage or intracranial aneurysm. Subarachnoid hemorrhage
from an aneurysm is a catastrophic event with significant morbidity and
Assessment and Diagnostic Findings ANSWER :-Any patient with suspected stroke should undergo a CT
scan or MRI to determine the type of stroke, the size and location of the hematoma, and the presence
or absence of ventricular blood and hydrocephalus. Cerebral angiography confirms the diagnosis of an
intracranial aneurysm or AVM. These tests show the location and size of the lesion and provide
information about the affected arteries, veins, adjoining vessels, and vascular branches. Lumbar
puncture is performed if there is no evidence of increased ICP, the CT scan results are negative, and
subarachnoid hemorrhage must be confirmed. Lumbar puncture in the presence of increased ICP could
